Graduation Date
2026
Document Type
Doctoral Dissertation
Project Type
Mixed Methods
Degree Name
Doctor of Philosophy in Art Therapy
Program
Art Therapy
Program Director
Lisa Hinz, PhD, ATR-BC
First Reader
Richard Carolan, EdD, ATR-BC
Second Reader
Lisa Manthe, MFT, ATR-BC
Abstract
This mixed-methods dissertation examined the therapeutic potential of the Tree Ring Self-Portrait, a novel art therapy intervention designed to enhance self-acceptance and reduce anxiety through symbol-based, life-phase self-portraiture grounded in narrative meaning-making and image-based processing (White & Epston, 1990; Moon, 2010; Hinz, 2020). Adults who self-identified with anxiety-related concerns were recruited through community and clinical referral sources and completed a standardized three-session intervention involving reflective mapping of life phases, a watercolor-based concentric-ring self-portrait process, and a guided review of the completed artwork with semi-structured interviews. The final sample (n = 20; ages 22–74) included participants with varied engagement in psychotherapy and/or medication use.
Quantitative outcomes were assessed pre- and post-intervention using the Generalized Anxiety Disorder–7 (GAD-7; Spitzer et al., 2006) and the Unconditional Self-Acceptance Questionnaire (USAQ; Chamberlain & Haaga, 2001). Results indicated a statistically significant decrease in anxiety (GAD-7 pre: M = 14.05, SD = 4.78; post: M = 8.95, SD = 3.78), t(19) = 8.29, p < .001, d = 1.85, alongside a statistically significant increase in unconditional self-acceptance (USAQ pre: M = 78.95, SD = 11.08; post: M = 91.65, SD = 11.94), t(19) = −6.78, p < .001, d = 1.52.
Change-score analyses demonstrated a moderate association between reductions in anxiety and increases in self-acceptance (r = −.51, p = .02). Qualitative analysis followed a phenomenological thematic approach informed by Kidd and Kidd’s (1997) framework, integrating participant language with participant-described visual symbolism. Four anxiety-related themes (overwhelm/emotional flooding; cognitive looping/temporal fixation; somatic/dissociative experience; threat, safety, and relational rupture) and four self-acceptance–related themes (recognition of the whole life narrative; softening of self-evaluation/self-compassion; persistence/survival; openness and ongoing growth) were identified.
Mixed-methods integration indicated convergence between participant-described experiential shifts (e.g., reduced overwhelm, increased tolerance of anxiety, and increased self-compassion) and standardized outcome trends, supporting the Tree Ring Self-Portrait as a symbolically rich, tolerable, and clinically relevant art therapy intervention for adults experiencing anxiety (Loerinc et al., 2015; Hinz, 2020).
IRB Number
11284
Comments
The original Tree Ring Self Portrait Study.